BACKGROUNDFemales with acute myocardial infarction (AMI) have a higher risk of adverse outcomes because of receiving less evidence-based medical care. Our aim was to investigate the gender disparity in early death after ST-elevation myocardial infarction (STEMI) in the current era.

METHODSA total of 1429 consecutive patients with STEMI in the Liaoning district were analyzed. We compared hospital care and cardiac event data by sex for in-patients with acute STEMI within 24 hours of symptom onset.

RESULTSIn the emergency reperfusion group (n = 754), in-hospital mortality occurred in 4.2% of the males and 11.2% of the females (P = 0.001). In the non-emergency reperfusion group (n = 675), in-hospital mortality occurred in 13.0% of the males and 22.9% of the females (P = 0.001). Multivariate Logistic regression analysis revealed female sex as an independent risk factor of death for STEMI patients during hospitalization (OR = 1.691, P = 0.007). After controlling for patients who died within 24 hr after admission, female sex was no longer an independent risk factor (OR = 1.409, P = 0.259).

CONCLUSIONFemale sex was an independent risk factor for in-hospital mortality of STEMI patients, which is explained by an excess of very early deaths.